Submitted by Garrett Dejesus, MD, and Thomas J. Learch, MD.
Mrs. J. H.
History of present illness:
68-year-old female presenting to the emergency room with severe lower abdominal pain, nausea and vomiting. The patient reports a remote history of abdominal surgery for vague abdominal, discomfort. The surgery found no cause for her pain. She now reports acutely worsened abdominal pain.
Ulcerative colitis (mother)
Vital signs within normal limits
Moderately distended abdomen, tender in mid abdomen and left lower quadrant
WBC and lactate within normal limits
What diagnostic imaging test should be considered at this point?
A) MRI abdomen/pelvis
B) Abdominal plain film
C) Ultrasound abdomen
D) No imaging required: conservative care indicated at this time
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